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The timelines associated with the related investigations, and the potential for various actions to be taken in response, can make it challenging to identify a one-size-fits-all approach to addressing the impact of improper payments on Shared Savings Program calculations

As used in this subpart, the following definitions apply: 340B Program is the program under section 340B of the Public Health Service (PHS) Act

Nicotine can: Make blood sugar harder to control Increase insulin resistance, meaning insulin does not work as well Raise the risk of heart disease, which is already higher in diabetes Slow blood flow, which can affect healing and circulation Increase the risk of nerve damage and kidney problems over time What the Numbers Tell Us According to the CDC, people living with diabetes who use nicotine are 3040% more likely to develop heart disease compared to those who do not use nicotine Smoking or regular nicotine use can make it harder to reach target A1C levels Nicotine use increases the risk of diabetes-related complications, including problems with circulation and vision Vaping Still Delivers Nicotine Many people believe vaping is safer than smoking

Resources that may be helpful to understand the issue: What is Considered a Flavored Tobacco Product